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September 19, 2026JACC Case ReportsOpen Access

SGLT2i initiation in diverse HF patients demonstrates a ~21% one-year major CV event rate.

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Why the study?

SGLT2 inhibitors reduce heart failure hospitalizations and cardiovascular death, but Hispanic/Latino patients and methamphetamine users have been under-represented in prior studies.

Do SGLT2 inhibitors improve cardiovascular outcomes in an ethnically diverse heart failure population, including methamphetamine users?

Population

413 heart failure patients in Central Valley, California, 72% non-White, 27% methamphetamine users

Comparison

Outcomes before and after starting SGLT2 inhibitors

Design

Retrospective cohort study

Follow-up

12 months

Key result

Among 413 ethnically diverse patients with heart failure, the composite CV outcome occurred in 20.8% within 12 months of starting an SGLT2 inhibitor.

Authors

SLSun Yong LeeTVTiffany VuJSJessica Song

Discussion

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Member takes

Overview

May inform real-world expectations in diverse HF populations; extends RCT data to ethnic minorities and methamphetamine users but remains hypothesis-generating.

Key Points

  • To evaluate 12-month cardiovascular outcomes following the initiation of sodium-glucose cotransporter 2 inhibitors in an ethnically diverse cohort of patients with heart failure.
  • Conducted a retrospective study of 413 patients with heart failure initiating SGLT2 inhibitor therapy in the Central Valley region of California.
  • Tracked cardiovascular outcomes over 12 months in a population comprising 72% non-White patients and 27% methamphetamine users.
  • The composite cardiovascular outcome occurred in 86 of 413 patients (20.8%), including 22% of White patients and 19% to 27% of non-White patients.
  • Heart failure hospitalization rates decreased significantly across the overall cohort and within subgroups after 1 year of SGLT2 inhibitor therapy.
  • Reduced left ventricular ejection fraction, prior heart failure hospitalization, and methamphetamine use significantly predicted cardiovascular outcomes irrespective of ethnicity.

Study Design

Type

Cohort (n=413)

Structured PICO

Do SGLT2 inhibitors improve cardiovascular outcomes in an ethnically diverse heart failure population, including methamphetamine users?

P
Population
413 ethnically diverse patients with heart failure, including 72% non-White patients and 27% methamphetamine users, followed for 12 months after starting an SGLT2 inhibitor.
E
Exposure
Sodium-glucose cotransporter 2 inhibitors (SGLT2is)
O
Outcome
Composite cardiovascular (CV) outcome within 12 months of starting a SGLT2icomposite

SGLT2 inhibitors are associated with reduced heart failure hospitalizations at 1 year in a diverse real-world cohort, though methamphetamine use, prior HFH, and reduced LVEF remain strong predictors of adverse cardiovascular outcomes.

Limitations

  • The retrospective nature of this analysis limits causal inference
  • Retrospective nature of the analysis limits causal inference

Cite This Study

Lee et al. (2026) conducted a cohort in Heart failure (n=413). Sodium-glucose cotransporter 2 inhibitors (SGLT2is) was evaluated on Composite CV outcome. Among 413 ethnically diverse patients with heart failure, the composite CV outcome occurred in 20.8% within 12 months of starting an SGLT2 inhibitor.

synapsesocial.com/papers/6aae47640c69660b71ecc64fhttps://doi.org/10.1016/j.jaccas.2026.109454
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Association of Sodium-Glucose Cotransporter 2 Inhibitors With Cardiovascular Outcomes in Patients With Type 2 Diabetes and Other Risk Factors for Cardiovascular Disease2022 · 83 citations
  2. 2Cardiovascular Outcome in Patients Treated With SGLT2 Inhibitors for Heart Failure: A Meta-Analysis2021 · 43 citations
  3. 3The Role of SGLT2 Inhibitors on Heart Failure Outcomes in Nondiabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials2023 · 15 citations
  4. 4Contemporary Use of Sodium Glucose Co-Transporter 2 Inhibitors in Hospitalized Heart Failure Patients: A “Real-World” Experience2024 · 1 citations
  5. 5Racial Differences in Quality of Life in Patients With Heart Failure Treated With Sodium–Glucose Cotransporter 2 Inhibitors: A Patient-Level Meta-Analysis of the CHIEF-HF, DEFINE-HF, and PRESERVED-HF Trials2023 · 7 citations